Andrea Sue Coston, LSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

150111370 Issued in IL

Practice address

102 E. Chestnut
Bloomington, IL 61701

Phone

(309) 490-3060

Fax

(704) 980-3082

NPI assigned

Sep 8, 2022

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Andrea Sue Deckinga Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1662595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747180800000",
    "number": "1548981582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 MANCHESTER RD",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617611520",
            "telephone_number": "309-826-3878",
            "fax_number": "704-980-3082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 E. CHESTNUT",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "61701",
            "telephone_number": "309-490-3060",
            "fax_number": "704-980-3082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTON",
        "first_name": "ANDREA",
        "middle_name": "SUE",
        "name_prefix": "Mrs.",
        "credential": "LSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-08",
        "last_updated": "2025-05-14",
        "certification_date": "2022-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P018410",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "150111370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "DECKINGA",
            "middle_name": "SUE",
            "credential": "LSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Nancy Jannet Cortez
• J Jay Corwin, MD
• Valerie A. Corwin, PA-C
• Melissa Costello-McKee
• Megan Leigh Costenson
• Cottage Dental Care LLC
• Kristine L Cottone, P.T.
• Justin Joseph Couch, NP-C
• Laura Coughlin
• John Francis Couillard, O.D.

• Clinical Social Worker in Bloomington, IL
• Providers in Bloomington, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.